Journal of Neonatal-Perinatal Medicine - Volume 17, issue 5

Authors: Vaidya, Ruben | Hashmi, Nabeel | Kakshapati, Salima | Chang, Weijen | Beachy, Joanna

Article Type: Research Article

Abstract: BACKGROUND: Post natal adaptation syndrome is well reported but early presentation of neurological symptoms severe enough to warrant detailed neurological work up is rare. Our aim was to evaluate and describe abnormal early neurological symptoms in infants following in-utero exposure to a varying combination of selective serotonin uptake inhibitor medication and other psychotropic medications, with negative seizure work-up. METHOD: Descriptive case series of infant exposed to selective serotonin uptake inhibitor medication and other psychotropic medications, presenting with early neurologic signs and symptoms within the first 24 hours of life concerning for seizures, who underwent an extensive neurologic evaluation. …RESULTS: Five infants met criteria. Infant #1 : 39-weeks gestational age (GA), with escitalopram, clonazepam, gabapentin, methadone exposure, presented with generalized hypertonia and intermittent back-arching. #2 : 40-weeks GA with escitalopram and hydroxyzine exposure, with bilateral arm stiffening and sucking mouth movements. #3 : 34-weeks GA with fluoxetine, quetiapine and clonazepam exposure, presented with decerebrate posturing. #4 : 38-weeks GA with fluoxetine, clonazepam, clonidine, quetiapine and gabapentin exposure, presented with asynchronous tremoring of all extremities. #5 : 35-weeks GA with citalopram, quetiapine exposure, presented with increased tone and posturing of upper extremities. Electroencephalogram was negative for seizures in all infants. CONCLUSION: In-utero exposure to selective serotonin uptake inhibitor medication, especially in combination with other psychotropic medications, may be associated with significant abnormal neurological symptoms, which may not represent true seizures. Show more

Keywords: Post natal adaptation syndrome, seizure-like movements, selective serotonin uptake inhibitor

DOI: 10.3233/NPM-230165

Citation: Journal of Neonatal-Perinatal Medicine, vol. 17, no. 5, pp. 717-722, 2024

Authors: Kumar, D. | Kumar, D. | Irfan, U. | Yadav, Y.S. | Yadav, R.K. | Kanti, V. | Sharma, P. | Shukla, S.K.

Article Type: Research Article

Abstract: BACKGROUND: Perfusion index (PI) and CRIB (Clinical risk index of babies) Score II both are minimally invasive tools for prediction of mortality and morbidity in sick neonates. This study aims to know the predictive values of both PI and CRIB Score II in assessment of severity of illness in preterm neonates of 28 to 32 weeks and their correlation. METHODS: PI and CRIB II Score of 125 sick preterm neonates admitted in NICU were assessed within 12 hours of admission. Severity noted in form of outcome. Correlation between PI and CRIB Score II were observed. RESULTS: …Receiver operating characteristic (ROC) curve were plotted for PI and CIRB Score II with outcome (discharged vs expired). Area under curve for perfusion index was 0.776 at 95% confidence interval. Optimum cutoff point based on ROC curve was 1.65 with sensitivity of 84%., specificity of 37.2% with positive predictive value of 70% and negative predictive value of 57%. Area under curve for CRIB Score II was 0.622 (p value < 0.028), optimum cut off point based on ROC curve for CRIB II score was 3.5 with sensitivity 79.10% of specificity of 40% positive predictive value is 43.03% and negative predictive value of 76.9%. Spearman’s correlation coefficient between PI and CRIB II score was –0.272 and p value is 0.002. CONCLUSION: This study concluded that perfusion index (p  < 0.001) is better for predicting the severity compared to CRIB II score (p  < 0.028). A weak negative correlation exists between PI and CRIB II score (r  = –0.272). Show more

Keywords: Area under curve, confidence interval, perfusion index, preterm-neonates, receiver operating characteristic

DOI: 10.3233/NPM-240084

Citation: Journal of Neonatal-Perinatal Medicine, vol. 17, no. 5, pp. 723-730, 2024

Article Type: Correction

DOI: 10.3233/NPM-249007

Citation: Journal of Neonatal-Perinatal Medicine, vol. 17, no. 5, pp. 731-731, 2024